Background: Identifying service gaps that compromise community health is essential for STD prevention programs. We piloted a tool designed to assess gaps in STD prevention services for adolescents and MSM, two priority populations for U.S. STD prevention efforts. The tool is a checklist of essential and desirable services pertinent to adolescent and MSM sexual health, along with a means to capture who provides the services and the organizations with which they partner.
Methods: STD program staff identified providers serving MSM or adolescents in a city of 969,000 people in North Carolina; rates of HIV 33.7/100,000 and P&S Syphilis 9.3/100,000 in 2012. Providers were interviewed regarding available services, perceived service gaps and partnerships. Data were analyzed using field-based and qualitative techniques.
Results: The pilot tool was given to providers (N=18) representing 8 of the 12 facilities identified by regional staff (N=12). Locations of interviewed providers were juxtaposed with case report data. Most were located in the top 5 zip codes for syphilis and HIV cases. Seven facilities offered HIV screening, 6 offered clinical services, 3 had patient navigators, 3 offered support groups for HIV-affected clients, and all used client referrals to augment services. The tool was useful for capturing STD prevention services and partnerships, but less so for services relevant to sexual health for HIV-infected clients. Gaps named by facility representatives included: transportation, lack of STD services, case management, women’s and adolescents services, mental health services, and working with youth in schools. STD program staff and providers often identified the same service gaps.
Conclusions: An STD prevention services gap analysis tool is useful in identifying gaps in services for MSM & adolescents. Modifications are needed to improve its utility, including assessing the needs of HIV-affected STD clients. Relevant lessons learned were garnered for conducting gap assessments by State and local areas.